The human shoulder is one of the most extraordinary parts of the human body, considering it has developed to such a degree it enables a complex range of motion in all directions. The acromioclavicular joint is the joint that is predominantly compressed during rotational movements, simultaneously contributing to shoulder gridle stabilization· the juncture where the acromion–at the uppermost part of the scapula– and the lateral end of the clavicle meet.
One of the most common shoulder injuries that is caused by either a direct blow to the shoulder or when falling on the ground, is a rupture of the acromioclavicular ligaments, resulting in ‘‘separation’’ (detachment) of the clavicle from the acromion. Young athletes are considered to be more susceptible to this type of injuries (boys are more injury-prone than girls), as well as individuals who participate in contact sports, whereas car crashes and motorcycle or bicycle accidents are likely to result in acromioclavicular joint dislocations.

Depending on the force of the blow or fall, the injury may vary from acromioclavicular ligament distension (sprain), acromioclavicular ligament tear and coracoclavicular ligament distension, or simultaneous acromioclavicular and coracoclavicular ligament tears and superior displacement of the clavicle. In these cases (first 3 types of injuries), and consistently in relation to the patient’s age, level of physical activities and demands, treatment is generally conventional.
Acromioclavicular joint dislocations are additionally classified into 3 more types of injuries which are normally surgically treated: Simultaneous acromioclavicular and coracoclavicular ligament tears and, either posterior displacement of the clavicle through the trapezoid muscle, superior, or inferior displacement of the clavicle.

Conventional treatment includes medication in order to reduce the patient’s pain, ice packs and arm mobilization with the help of a sling. Most patients are capable of returning to their normal daily activities, even in cases where the deformity around the site of the injury persists, or when there is a degree of shoulder instability. In cases of minimal deformity but intense and chronic pain, a possible explanation is the abnormal contact between the bones during joint movement, or the patient suffering from arthritis or a damaged intra-articular cartilage disc, which acts as a shock-absorber between the acromion and the clavicle.
In cases where the patient’s quality of life is being affected by the pain and in chronic acromioclavicular joint dislocations, as well as in cases where the deformity around the site of the injury is extensive and there is limited shoulder function, surgical treatment is recommended. The joint is reconstructed and replaced by ligaments around the site of the injury or cadaver tendons, in combination with the use of strong sutures. Complete restoration of limb function is unachievable before 6 weeks have passed and the return to physical activities is usually estimated to happen 2 to 3 months postoperatively. 

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